Should anti-Rh immunoglobulin be given D variant women?

British Journal of Haematology
A LubenkoJ Habash

Abstract

D variant women occasionally form anti-D during or following pregnancy with a D-positive fetus. It is not known whether Rh immunization could be suppressed by using anti-Rh immunoglobulin (Rh Ig), or whether the injected antibodies would be absorbed by the woman's D variant cells. In order to predict the likely outcome, three anti-Rh Ig preparations were absorbed independently with five examples of D variant red cells: R1VIr (n = 3), R1Br (n = 2), and with cells of common Rh-positive and Rh-negative phenotypes: R0, r'r, r"r or rr cells (n = 1 each). The titres of the Ig preparations against all these cells were compared after three, six, nine and 12 absorptions. The titres of the unabsorbed anti-Rh Igs against R0 cells ranged from 2(15) to 2(18). Anti-D activities were hardly affected by absorption with r'r, r"r or rr cells, but were completely exhausted after three to six absorptions with R0 cells. Most of the D variant cells were as ineffective as rr cells in reducing anti-D activity against R0 cells, but one R1VIr variant produced a fall in titre against R0 cells, equivalent to four or five doubling dilutions after three to six absorptions, which could not be reduced further by subsequent absorptions. Therefore, a substantia...Continue Reading

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Citations

Sep 21, 2001·BJOG : an International Journal of Obstetrics and Gynaecology·S LurieM Glezerman
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Feb 26, 2013·British Journal of Haematology·Geoff Daniels
Jan 1, 1991·Clinical and Laboratory Haematology·K M MayneP J Bowell

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